| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$6,907 |
— |
| Abdomen 1 View (74018) |
— |
$286 |
— |
Abdomen 2 views (74019)
range across 2 matching MRF lines |
— |
$225–$363 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$2,481 |
— |
| Angio internal mammary (75756) |
— |
$3,127 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$5,533 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$5,316 |
— |
Ankle 2 views (73600)
range across 3 matching MRF lines |
— |
$302–$385 |
— |
| Aortography thoracic serialography rs&i (75605) |
— |
$10,767 |
— |
| Artery X-Rays Abdomen (75726) |
— |
$11,066 |
— |
| Artery X-Rays Pelvis (75736) |
— |
$10,767 |
— |
| Arthrogram ankle (73615) |
— |
$1,309 |
— |
| Arthrogram hip (73525) |
— |
$1,309 |
— |
| Arthrogram Wrist (73115) |
— |
$1,309 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$824 |
— |
| Bone age studies (77072) |
— |
$241 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$1,664 |
— |
| Bone Imaging Limited Area (78300) |
— |
$1,523 |
— |
| Bone Imaging Whole Body (78306) |
— |
$1,583 |
— |
| Bone marrow imaging limited area (78102) |
— |
$1,133 |
— |
| Bone marrow imaging; whole body (78104) |
— |
$1,133 |
— |
| Bone survey infant (77076) |
— |
$469 |
— |
| Brachytx isodose complex (77318) |
— |
$1,526 |
— |
| Brachytx isodose intermed (77317) |
— |
$1,227 |
— |
| Brachytx Isodose Plan Simple (77316) |
— |
$681 |
— |
| Brain Imaging Pet Metabolic Evaluation (78608) |
— |
$6,533 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$561 |
— |
| Cerebrospinal Fluid Scan (78630) |
— |
$1,205 |
— |
Chest 1 view (71045)
range across 4 matching MRF lines |
— |
$146–$241 |
— |
Chest 2 views (71046)
range across 8 matching MRF lines |
— |
$60–$345 |
— |
| Chest 3 views (71047) |
— |
$389 |
— |
| Chest 4 or more views (71048) |
— |
$423 |
— |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
— |
$384 |
— |
Clavicle complete (73000)
range across 3 matching MRF lines |
— |
$441–$662 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$378 |
— |
| Continuing medical physics consltj pr wk (77336) |
— |
$686 |
— |
| Contrast Exam Abdominl Aorta (75625) |
— |
$5,081 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$959 |
— |
| Contrast X-Ray Of Elbow (73085) |
— |
$1,309 |
— |
| Contrast X-Ray Of Knee Joint (73580) |
— |
$1,309 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$4,600 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$3,456 |
— |
| CT abdomen w contrast (74160) |
— |
$2,615 |
— |
| CT abdomen w wo contrast (74170) |
— |
$3,265 |
— |
| CT abdomen w/o contrast (74150) |
— |
$2,208 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$3,876 |
— |
| CT Angio Chest (71275) |
— |
$2,686 |
— |
| CT Angio Head (70496) |
— |
$3,125 |
— |
| CT angio hrt w/3d image (75574) |
— |
$1,916 |
— |
Ct Angio Lwr Extr W/O&W/Dye (73706)
range across 3 matching MRF lines |
— |
$2,398–$2,732 |
— |
| CT Angio Neck (70498) |
— |
$2,535 |
— |
Ct Angio Upr Extrm W/O&W/Dye (73206)
range across 3 matching MRF lines |
— |
$2,061–$2,271 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$3,156 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$2,248 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$1,762 |
— |
| CT chest w contrast (71260) |
— |
$2,221 |
— |
| CT chest w/wo contrast (71270) |
— |
$3,160 |
— |
| CT head/brain with contrast (70460) |
— |
$1,605 |
— |
| CT head/brain without and with contrast (70470) |
— |
$2,754 |
— |
| CT iac w contrast (70481) |
— |
$2,253 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$1,762 |
— |
CT lower ext w/o (73700)
range across 15 matching MRF lines |
— |
$1,694–$1,975 |
— |
CT lower extremity w/contrast material (73701)
range across 3 matching MRF lines |
— |
$2,962–$4,443 |
— |
| CT lumbar spine w contrast (72132) |
— |
$3,156 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$2,248 |
— |
| CT maxillofacial w contrast (70487) |
— |
$2,496 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$1,988 |
— |
| CT neck tissue combo (70492) |
— |
$2,858 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$2,681 |
— |
| CT orbits w/o contrast (70480) |
— |
$2,245 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$2,632 |
— |
| CT pelvis w/o contrast (72192) |
— |
$1,527 |
— |
CT scan of leg combo (73702)
range across 3 matching MRF lines |
— |
$2,021–$2,762 |
— |
| CT scans face/jaw combo (70488) |
— |
$2,802 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$2,616 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$2,374 |
— |
| CT thoracic spine w contrast (72129) |
— |
$2,552 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$2,280 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$3,037 |
— |
| CT thorax w/o contrast (71250) |
— |
$1,664 |
— |
CT upper ext wo (73200)
range across 6 matching MRF lines |
— |
$1,716–$2,574 |
— |
CT upper extremity w/o & w/contrast material (73202)
range across 3 matching MRF lines |
— |
$1,910–$2,243 |
— |
CT upper extremity with contrast (73201)
range across 3 matching MRF lines |
— |
$1,605–$1,782 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$2,881 |
— |
| Cta Abdomen (74175) |
— |
$3,115 |
— |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
— |
$4,600 |
— |
| Discography Cerv/Thor Spine (72285) |
— |
$4,113 |
— |
| Diskography lumbar (72295) |
— |
$4,113 |
— |
| Dxa Bone Density Axial (77080) |
— |
$615 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$287 |
— |
| Echo exam uterus (76831) |
— |
$491 |
— |
| Echo Guide For Artery Repair (76936) |
— |
$794 |
— |
| Esophagram (74220) |
— |
$618 |
— |
Fetal Biophys Profile W/Nst (76818)
range across 2 matching MRF lines |
— |
$173–$326 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$673 |
— |
Fluoroscopy up to 1 hr (76000)
range across 8 matching MRF lines |
— |
$386–$491 |
— |
Follow-Up Angiography (75898)
range across 5 matching MRF lines |
— |
$787–$1,337 |
— |
Foot 2 views (73620)
range across 3 matching MRF lines |
— |
$302–$385 |
— |
Forearm 2 views (73090)
range across 3 matching MRF lines |
— |
$302–$421 |
— |
| Gastric emptying imaging study (78264) |
— |
$1,712 |
— |
| Gated Heart Planar Single (78472) |
— |
$2,019 |
— |
Hand 2 views (73120)
range across 3 matching MRF lines |
— |
$279–$476 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$2,005 |
— |
| Hepatobiliary System Imaging (78226) |
— |
$1,965 |
— |
| Ht Muscle Image Spect Sing (78451) |
— |
$2,481 |
— |
| Hysterosalpingogram (74740) |
— |
$1,292 |
— |
| Image fusion (77399) |
— |
$368 |
— |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
— |
$311 |
— |
| Interstitial radiation source applic complex (77778) |
— |
$2,973 |
— |
| Intracavitary Radiation Source Applic Complex (77763) |
— |
$2,973 |
— |
| Intracavitary Radiation Source Applic Intermed (77762) |
— |
$2,973 |
— |
| Intracavitary radiation source applic simple (77761) |
— |
$1,289 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$1,869 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$1,549 |
— |
| Kidney Imaging Morphol (78700) |
— |
$1,133 |
— |
Knee 3 Views (73562)
range across 3 matching MRF lines |
— |
$276–$476 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$2,481 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$2,481 |
— |
| Lymph System Imaging (78195) |
— |
$2,481 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$2,414 |
— |
| Mammary ductogram or galactogram multiple (77054) |
— |
$713 |
— |
| Mammary ductogram or galactogram single (77053) |
— |
$475 |
— |
| Meckels Divert Exam (78290) |
— |
$1,492 |
— |
| Mlc imrt design & construction per imrt plan (77338) |
— |
$2,292 |
— |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
— |
$54 |
— |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
— |
$202 |
— |
| Mr safety implt pos&/immoblj (76019) |
— |
$131 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$4,749 |
— |
| MRA head w/o contrast (70544) |
— |
$3,270 |
— |
| MRA head with contrast (70545) |
— |
$2,948 |
— |
| MRA neck w contrast (70548) |
— |
$3,083 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$4,794 |
— |
| MRA neck w/o contrast (70547) |
— |
$2,777 |
— |
| MRI abdomen w contrast (74182) |
— |
$2,948 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$2,777 |
— |
MRI any jt lower extrem w/contrast material (73722)
range across 12 matching MRF lines |
— |
$3,685–$3,821 |
— |
MRI any jt lower extrem w/o & w/contrast matrl (73723)
range across 12 matching MRF lines |
— |
$5,305–$5,505 |
— |
MRI any jt upper extremity w/contrast matrl (73222)
range across 9 matching MRF lines |
— |
$3,685–$3,921 |
— |
| MRI Breast W/O Contrast Bilateral (77047) |
— |
$4,344 |
— |
| MRI Breast Without Contrast Material Unilateral (77046) |
— |
$3,441 |
— |
| MRI cervical spine w contrast (72142) |
— |
$3,623 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$3,472 |
— |
| MRI chest w/o contrast (71550) |
— |
$3,446 |
— |
| MRI chest with contrast (71551) |
— |
$2,777 |
— |
| MRI chest wo w contrast (71552) |
— |
$4,749 |
— |
MRI lower extrem oth/thn jt w/contrast matrl (73719)
range across 18 matching MRF lines |
— |
$2,948–$4,982 |
— |
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 18 matching MRF lines |
— |
$5,937–$6,102 |
— |
MRI lower extrem oth/thn jt w/o contr matrl (73718)
range across 18 matching MRF lines |
— |
$2,777–$3,564 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$3,623 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$5,937 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$2,777 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$2,948 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$5,937 |
— |
| MRI pelvis w contrast (72196) |
— |
$2,948 |
— |
MRI pelvis w/o & w contrast (72197)
range across 3 matching MRF lines |
— |
$2,777–$5,491 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$2,777 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$3,472 |
— |
MRI upper extremity oth than jt w/contr matrl (73219)
range across 3 matching MRF lines |
— |
$2,948–$3,126 |
— |
MRI upper extremity oth than jt w/o contr matrl (73218)
range across 21 matching MRF lines |
— |
$2,777–$2,983 |
— |
Mri Uppr Extremity W/O&W/Dye (73220)
range across 21 matching MRF lines |
— |
$4,749–$4,911 |
— |
| MRI, abdomen, combo (74183) |
— |
$4,749 |
— |
| MRI, dorsal spine combo (72157) |
— |
$5,937 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$3,623 |
— |
MRI, joint upper extrem (73221)
range across 9 matching MRF lines |
— |
$2,777–$2,983 |
— |
MRI, joint upper extrem combo (73223)
range across 9 matching MRF lines |
— |
$4,749–$4,911 |
— |
| MRI, lumbar spine combo (72158) |
— |
$5,937 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$3,740 |
— |
| Neck soft tissue (70360) |
— |
$276 |
— |
| Ntsty modul radthx pln dose-vol histos (77301) |
— |
$8,317 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$1,451 |
— |
| Parathyroid imaging w/tomographic spect & CT (78072) |
— |
$1,572 |
— |
| Parathyroid planar imaging w/wo subtraction (78071) |
— |
$1,190 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$280 |
— |
| Peritoneogram Rs&I (74190) |
— |
$1,103 |
— |
| Pet Image W/Ct Lmtd (78814) |
— |
$6,533 |
— |
| PET image w/CT, full body (78816) |
— |
$6,533 |
— |
| PET imaging CT attenuation skull base mid-thigh (78815) |
— |
$7,354 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$2,481 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$469 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$640 |
— |
Radex Ankle Complete Minimum 3 Views (73610)
range across 3 matching MRF lines |
— |
$345–$488 |
— |
Radex Calcaneus Minimum 2 Views (73650)
range across 3 matching MRF lines |
— |
$345–$385 |
— |
Radex elbow complete minimum 3 views (73080)
range across 3 matching MRF lines |
— |
$345–$476 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$276 |
— |
Radex fingr minimum 2 views (73140)
range across 3 matching MRF lines |
— |
$345–$402 |
— |
Radex foot complete minimum 3 views (73630)
range across 3 matching MRF lines |
— |
$345–$476 |
— |
Radex Hand Minimum 3 Views (73130)
range across 3 matching MRF lines |
— |
$276–$476 |
— |
Radex lower extremity infant minimum 2 views (73592)
range across 3 matching MRF lines |
— |
$276–$440 |
— |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
— |
$390 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$276 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$345 |
— |
Radex shoulder complete minimum 2 views (73030)
range across 3 matching MRF lines |
— |
$345–$518 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$276 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$276 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$276 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$311 |
— |
Radex Toe Minimum 2 Views (73660)
range across 3 matching MRF lines |
— |
$276–$440 |
— |
Radex upper extremity infant minimum 2 views (73092)
range across 3 matching MRF lines |
— |
$227–$339 |
— |
Radex Wrist Complete Minimum 3 Views (73110)
range across 3 matching MRF lines |
— |
$345–$476 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$530 |
— |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
— |
$22,888 |
— |
| Radiation treatment delivery level 1 (77402) |
— |
$545 |
— |
| Radiation treatment delivery level 2 (77407) |
— |
$708 |
— |
| Radiation treatment delivery level 3 (77412) |
— |
$900 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$390 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$862 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$1,035 |
— |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
— |
$771 |
— |
Radiologic exam knee complete 4/more views (73564)
range across 3 matching MRF lines |
— |
$403–$605 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$606 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$554 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$554 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$693 |
— |
Radiologic examination femur 1 view (73551)
range across 3 matching MRF lines |
— |
$155–$232 |
— |
Radiologic examination femur minimum 2 views (73552)
range across 3 matching MRF lines |
— |
$276–$476 |
— |
Radiologic examination knee 1/2 views (73560)
range across 3 matching MRF lines |
— |
$241–$385 |
— |
| Radiologic Examination Osseous Survey Limited (77074) |
— |
$339 |
— |
Radiologic examination tibia & fibula 2 views (73590)
range across 3 matching MRF lines |
— |
$345–$476 |
— |
| Ribs bilateral 3 views (71110) |
— |
$616 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$2,481 |
— |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
— |
$2,693 |
— |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
— |
$2,693 |
— |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
— |
$3,055 |
— |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
— |
$3,694 |
— |
| Rp Therapy Intravenous Administration (79101) |
— |
$1,299 |
— |
Scapula (73010)
range across 3 matching MRF lines |
— |
$345–$474 |
— |
Screening Digital Breast Tomosynthesis Bi (77063)
range across 5 matching MRF lines |
— |
$119–$124 |
— |
| Shoulder 1 view (73020) |
— |
$302 |
— |
Shoulder Arthrography (73040)
range across 3 matching MRF lines |
— |
$997–$1,595 |
— |
| Skull less than 4 views (70250) |
— |
$488 |
— |
| Special dosimetry (77331) |
— |
$355 |
— |
| Special Physics Consult (77370) |
— |
$1,377 |
— |
| Special teletherapy port plan (77321) |
— |
$2,155 |
— |
| Special treatment procedure (77470) |
— |
$2,578 |
— |
| Stereotactic Body Radiation Delivery (77373) |
— |
$4,769 |
— |
| Sternoclavicular joints (71130) |
— |
$311 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$1,754 |
— |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
— |
$649 |
— |
Temporomandble Jt Arthrography Rs&I (70332)
range across 3 matching MRF lines |
— |
$482–$771 |
— |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
— |
$2,193 |
— |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
— |
$1,147 |
— |
| Ther rad simulaj-aided field setting simple (77280) |
— |
$1,057 |
— |
| Thoracic spine 2 views (72070) |
— |
$345 |
— |
| Thoracic spine 3 views (72072) |
— |
$429 |
— |
| Thoracolumbar 2 views (72080) |
— |
$428 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$1,133 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$2,500 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$1,721 |
— |
| Tx Devices Design & Construction Complex (77334) |
— |
$1,237 |
— |
| Tx devices design & construction intermediate (77333) |
— |
$908 |
— |
| Tx devices design & construction simple (77332) |
— |
$652 |
— |
Ultrasound Breast Limited (76642)
range across 6 matching MRF lines |
— |
$334–$498 |
— |
| Ultrasound Elastography Parenchyma (76981) |
— |
$352 |
— |
| Ultrasound Exam Aaa Screen (76706) |
— |
$562 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$703 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$326 |
— |
| Upper gi w/o kub (74240) |
— |
$612 |
— |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
— |
$247 |
— |
| Ureteral Reflux Study (78740) |
— |
$1,312 |
— |
| Urethrocystogram voiding (74455) |
— |
$1,075 |
— |
| Urethrocystography retrograde (74450) |
— |
$959 |
— |
Us breast unilateral complete (76641)
range across 11 matching MRF lines |
— |
$711–$1,067 |
— |
| Us chest (76604) |
— |
$597 |
— |
| Us exam, pelvic, limited (76857) |
— |
$562 |
— |
| Us kidney transplant (76776) |
— |
$903 |
— |
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882)
range across 7 matching MRF lines |
— |
$311–$894 |
— |
| Us ob detailed single fetus (76811) |
— |
$724 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$545 |
— |
| Us ob transvaginal (76817) |
— |
$747 |
— |
Us pelvic non ob complete (76856)
range across 2 matching MRF lines |
— |
$475–$980 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$764 |
— |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
— |
$545 |
— |
| Us retroperitoneal complete (76770) |
— |
$681 |
— |
| Us retroperitoneal limited (76775) |
— |
$597 |
— |
| Us scrotum and contents (76870) |
— |
$597 |
— |
| Us spinal canal and contents (76800) |
— |
$311 |
— |
| Us thyroid (76536) |
— |
$700 |
— |
| Vein X-Ray Chest (75827) |
— |
$1,703 |
— |
Venogram Sinus/Jugular (75860)
range across 4 matching MRF lines |
— |
$1,703–$3,127 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$5,276 |
— |
| Venography extremity bilateral rs&i (75822) |
— |
$1,985 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$1,703 |
— |
| Venography Renal Bilateral (75833) |
— |
$6,059 |
— |
| Venography Renal Unilateral (75831) |
— |
$6,059 |
— |
Wrist 2 views (73100)
range across 3 matching MRF lines |
— |
$276–$443 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$276 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$597 |
— |
| X-Ray Aorta Leg Arteries (75630) |
— |
$5,276 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$469 |
— |
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 3 matching MRF lines |
— |
$405–$608 |
— |
X-Ray Exam Breast Specimen (76098)
range across 8 matching MRF lines |
— |
$645–$773 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$345 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$774 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$499 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$155 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$276 |
— |
| X-Ray Exam Hip Uni 4/> Views (73503) |
— |
$867 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$498 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$523 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$548 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$725 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$345 |
— |
X-Ray Exam Neck Spine 6/>Vws (72052)
range across 9 matching MRF lines |
— |
$173–$862 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$389 |
— |
X-ray eye for foreign body (70030)
range across 3 matching MRF lines |
— |
$276–$414 |
— |
X-ray humerus (73060)
range across 3 matching MRF lines |
— |
$304–$476 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$777 |
— |
| X-ray IV pyelogram+tomography (74415) |
— |
$959 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$276 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$241 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$315 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$276 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$469 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$488 |
— |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
— |
$345 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$345 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$487 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$390 |
— |
| X-Ray Stress View (77071) |
— |
$190 |
— |
| X-ray thoracic spine 4 vw (72074) |
— |
$440 |
— |
| X-Ray Tmj Unilat (70328) |
— |
$276 |
— |
X-Ray Urinary Tract Exam With Contrast Material (74420)
range across 6 matching MRF lines |
— |
$959–$1,672 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$469 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$769 |
— |
Xr c-spine 4 or 5 views (72050)
range across 9 matching MRF lines |
— |
$173–$469 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$390 |
— |
| Xr orbits complete 4 views (70200) |
— |
$390 |
— |